Policy Updates

CMS to Look at Accrediting Agencies

Health care accrediting organizations will be the subject of scrutiny and possible action by the federal government in the coming months. At a recent conference, Centers for Medicare & Medicaid Services administrator Seem Verma said that Receiving CMS’s authorization to inspect and deem healthcare providers compliant with Medicare’s quality standards is nothing short of assuming a sacred public trust…But an increasing amount of evidence indicates that accrediting organizations are not living up to that high bar. According to Verma, CMS’s interest is motivated by a number of recent incidents of “serious deficiencies” among hospitals that had been found compliant with [...]

iqtsupport2020-02-27T06:00:36-05:00February 27, 2020|Centers for Medicare & Medicaid Services|

A Tax on Businesses With Workers on Medicaid?

Businesses with more than 50 employees enrolled in Medicaid would pay a fee, or tax, under a proposal by New Jersey Governor Phil Murphy. Murphy’s “corporate responsibility fee” would levy a tax of $325 per employee on companies with between 50 and 500 employees on Medicaid. The companies would pay the same fee for the members of their employees’ families who are enrolled in Medicaid as well. Companies with more than 500 workers on Medicaid would pay a higher fee and the tax would rise to $725 per employee for businesses with more than 1000 employees on Medicaid. The proposal [...]

iqtsupport2020-02-26T06:00:52-05:00February 26, 2020|Medicaid|

Supreme Court Paves Way for Public Charge Regulation

The revised public charge regulation that will make it more difficult for some immigrants to come to the U.S. will be implemented after the Supreme Court lifted preliminary injunctions issued by lower courts that delayed the regulation’s implementation. Under revisions of the public charge regulation introduced last year, individuals seeking entry into the U.S. and green cards who do not appear to be financially independent or have employment commitments can be denied entry if they will be dependent on means-tested public aid programs such as Medicaid or food stamps or even if they, or members of their family, appear likely [...]

iqtsupport2020-02-24T10:38:18-05:00February 24, 2020|hospitals, Medicaid|

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company. MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could …reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone. States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications. Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch [...]

iqtsupport2020-02-18T13:28:21-05:00February 18, 2020|hospitals, Medicaid, Medicaid regulations|

340B Déjà Vu: CMS Seeks to Collect Data From Hospitals

For the second time in four months, the federal government has announced its intention to collect data from hospitals and other providers on what they pay for the prescription drugs they purchase through the section 340B prescription drug discount program. Last week the Centers for Medicare & Medicaid Services published a notice announcing its intention to collect this data. Previously, health care interests sued CMS when it attempted in 2018 to reduce payments to providers for drugs purchased through the 340B program and the court ruled against CMS, maintaining that the agency did not have enough data on hospitals’ acquisition [...]

iqtsupport2020-02-12T06:00:24-05:00February 12, 2020|340b, Centers for Medicare & Medicaid Services|

Verma Responds to Medicaid Block Grant Critics

Last week the Trump administration unveiled its Healthy Adult Opportunity program, a new, optional, already-controversial approach to structuring state Medicaid programs. Ever since, the program – essentially, Medicaid block grants – has been the subject of criticism from many public officials and health care stakeholders. Now, Centers for Medicare & Medicaid Services administrator Seema Verma, who oversaw the development of Healthy Adult Opportunity, has responded to the program’s critics in an op-ed piece published in the Washington Post. See her commentary “No, the Trump administration is not cutting Medicaid.”

iqtsupport2020-02-11T11:55:58-05:00February 11, 2020|Centers for Medicare & Medicaid Services, Medicaid|

Health Care Groups Rebel Against Proposed Federal Regulation, Program

The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups. The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them. The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal [...]

iqtsupport2020-02-07T06:00:27-05:00February 7, 2020|Centers for Medicare & Medicaid Services, DeBrunner & Associates, hospitals, Medicaid, Medicaid regulations|

Implications of Medicaid Block Grants

States will be able to pursue new Medicaid block grants under guidance recently sent by federal regulators to state Medicaid directors. But what does that mean? In a new article, the Commonwealth Fund examines how the Centers for Medicare & Medicaid Services’ Medicaid block grants will work (for states that choose to pursue them; they are not mandatory), the new flexibility block grants will give states, and how the new approach will give states some relief from CMS oversight and delivery system requirements. Learn more from the Commonwealth Fund article “What Does New Block Grant Guidance Mean for the Medicaid [...]

iqtsupport2020-02-06T10:04:51-05:00February 6, 2020|Medicaid|

Hundreds of Hospitals Penalized for Medical Mistakes

786 hospitals will see their Medicare payments slashed one percent for a year because of their performance under Medicare’s hospital-acquired conditions reduction program. That program penalizes the 25 percent of hospitals with the highest rate of patient safety problems, such as infections and injuries. Among the more interesting aspects of this year’s program results: Among those being penalized are seven of the 21 hospitals on the S. News “best hospitals” list. Three hospitals also on that list have never been penalized. 145 hospitals will be penalized for the first time. 16 hospitals that have been penalized every year since the [...]

iqtsupport2020-02-05T06:00:24-05:00February 5, 2020|Medicare, Medicare regulations, Medicare reimbursement policy|

Not Surprisingly, Higher Medicaid Rates Improve Access

Higher Medicaid payments for substance abuse disorder treatment lead to better access to such treatment, a new report by the U.S. Government Accountability Office has concluded. According to the study, which focused on six states, State officials and SUD [substance abuse disorders] providers in the selected states with larger rate changes reported greater effects on SUD service availability compared to those in states with smaller changes. For example, state officials said that larger rate increases helped increase the number of SUD providers participating in Medicaid, but did not generally note SUD service availability effects for smaller rate increases. Providers in [...]

iqtsupport2020-02-04T06:00:57-05:00February 4, 2020|Medicaid|